Treatment of pneumonia in a nursing mother. Left-sided pneumonia in nursing mothers

Pneumonia is an acute infectious disease caused by viruses, bacteria or even fungi. In the practice of a doctor, there is also pneumonia that occurs around an oncological focus (lung cancer), the so-called "paracancrotic pneumonia". Until now, the incidence and even mortality from this disease remains high, especially in children and the elderly. If before the discovery of antibiotics, mortality was about 80%, today, thanks to modern diagnostics and adequate treatment, mortality ranges from 5% to 40% (mainly in the elderly).

With a mild course of the disease, it can be cured in 10 days. And thanks to modern drugs, even a severe course of the inflammatory process can pass without a trace. However, it must be remembered that this is an acute infectious disease that should be treated only under medical supervision.

Pneumonia disease

Pneumonia is an inflammatory process and occurs in the lung tissue. The most common cause of the disease is an infection. It enters the lungs mainly by airborne droplets, less often with blood flow. Normally, the immune system successfully copes with microorganisms that cause pneumonia. In cases where the immune system is weakened, the risk of getting pneumonia increases.

Very often, pneumonia occurs as a complication of diseases of the upper respiratory tract. It manifests itself against the background of some initial inflammatory process, for example, colds, bronchitis, tracheitis. Or after a serious illness, surgery, when the immune system is weakened and unable to cope with an additional infection.

With pneumonia, treatment is prescribed by a doctor. Basically, this is antibacterial therapy in conjunction with drugs that promote bronchial expansion and sputum discharge.

Pneumonia in adults and children responds well to treatment with modern drugs, provided that the patient consults a specialist in a timely manner. Antibacterial therapy effectively copes with inflammation. With inadequate treatment or severely weakened immunity, as well as late seeking medical help, serious complications may occur.

Like any inflammatory disease, pneumonia requires timely diagnosis and adequate treatment. This contributes to the effective restoration of health and the prevention of serious complications. Complications can spread to the lung tissue, causing severe illness that may require surgical care. They can also affect the cardiovascular system, which can manifest itself as an infectious-toxic shock.

Pneumonia in women

The development of pneumonia depends on many factors: the state of the immune system, social status, the presence of contact with patients, the presence of bad habits, and territorial location. There are no differences between the course, diagnosis and treatment of pneumonia between men and women. However, according to some scientists, women are less severely ill than men. Perhaps this is due to the presence of bad habits (primarily smoking) in men.

Pneumonia in pregnancy

Inflammation of the lungs during the time requires special monitoring by doctors. During this period, antibiotic therapy is selected with great care, depending on the duration of pregnancy and with caution so as not to harm the baby. The expectant mother is monitored not only by a therapist, but also by an obstetrician-gynecologist who controls the development of the fetus. Severe pneumonia and the appearance of dangerous complications may be an indication for abortion.

Pneumonia in breastfeeding mothers

Acute pneumonia is a contraindication for breastfeeding. This helps to avoid infection of the child, and also makes it possible to use effective antibiotic therapy without fear that the antibiotic will get to the baby with breast milk. When the acute condition is removed and the subsequent treatment of the mother does not threaten the health of the child, then feeding is resumed if there are no other contraindications.

Pneumonia in men

There are no special differences between pneumonia in women and men. However, men are more likely to have such a bad habit as smoking. And smokers, as a rule, have chronic bronchitis in 80% of cases. This means that there is a chronic inflammatory process in the bronchi, which not only suppresses local immunity, but also contributes to the development of infection in the lungs. Also, with prolonged smoking, the lung tissue itself is also affected. Develops pneumosclerosis (compaction of the lungs) and emphysema (impaired elasticity and airiness of the lung tissue). All this can lead to more rapid spread of inflammation in the lungs and more severe pneumonia in male smokers.

Pneumonia in children is now a fairly common disease. According to various sources, the incidence in children under 3 years old is 15-20 per 1000 babies, and over the age of 3 years - 5-6 per 1000 children. Children have additional risk factors for developing the disease:

• living conditions and nutrition (lack of proteins and vitamins),
• congenital malformations,
• trauma during childbirth
• fetal hypotrophy,
• aspiration (swallowing gastric contents when spitting up or getting a foreign body).

The smaller the child, the more severe the inflammation of the lungs. This is due to the imperfection of the immune system and the incompletely formed respiratory system: the lungs are not yet so airy (which disrupts gas exchange), the bronchi are narrow and, with the slightest inflammation, swelling of the mucous membrane occurs (which disrupts sputum discharge and promotes the reproduction of microorganisms), and special cilia bronchial mucosa is not yet able to evacuate sputum.

As for the clinical picture, in older children it is similar to the course in adults:

• an increase in body temperature (up to 38.5-40 degrees with the possible occurrence of seizures),
• cough (at first it may be dry, then with sputum, as a rule, appears on the 3rd-5th day of illness),
• chest pain when coughing and breathing deeply
• weakness,
• sweating,
• chills,
• decreased appetite,
• drowsiness,
• indifference to games.

As for babies, with the initial manifestations of pneumonia (runny nose, fever, loss of appetite - like a common ARVI), severe respiratory failure can quickly develop: pallor of the skin with a bluish tinge of the nasolabial triangle, increased breathing and heart rate, sweating, confusion, agitation ; the child may go into a coma.

Pneumonia in a newborn

Neonatal pneumonia is most common in premature babies. The disease can be transmitted from the mother herself (including intrauterine infection of the fetus) or received in a hospital. Pneumonia in newborns can develop against the background of insufficient intake of vitamins and proteins in the child's body. Also at risk include children who have undergone birth trauma, intrauterine oxygen starvation.

Mothers need to carefully monitor the condition of the child - the children's body is still weak, and a missed inflammatory process can adversely affect the health of the baby. It is important to pay attention to the change in the behavior of the newborn, his activity, appetite, discharge. If the child is lethargic, refuses to feed, often burps, diaper rash, nasal discharge, coughing appear - it is necessary to pay attention to this pediatrician. In case of fever, shortness of breath, blue skin in the face, feet, and palms, call an ambulance without waiting for the local doctor. Pneumonia in newborns requires urgent medical attention.

Symptoms of pneumonia

The onset of pneumonia in adults is often preceded by hypothermia (“got caught in the rain”, swimming in a cold pond, inconsistency of outer clothing with the temperature conditions of the weather). A typical picture of pneumonia:

• the onset is usually acute, a sharp rise in body temperature to high numbers is possible with chills
• symptoms of intoxication (weakness, headache, muscle pain throughout the body)
• in the future (3-5 days, possibly earlier) a cough appears (which may be dry at first, then with sputum)
• pain in the chest on the side of the lesion when coughing and deep breathing (sometimes patients feel the appearance of wheezing in the chest)
• the appearance of shortness of breath (indicates damage to a large area of ​​\u200b\u200bthe lung tissue and the development of respiratory failure)

It should be noted that the manifestation of pneumonia may not always be typical, and the symptoms of pneumonia largely depend on the pathogen that caused the inflammatory process, on the state of the human immune system and on the severity of the process itself. So, for example, the well-known "swine flu", which is caused by the H1N1 virus, is quite often complicated by the development of severe viral pneumonia, which quickly leads to damage to the lung tissue on both sides and severe respiratory failure, up to death.

Quite often, it all starts with SARS (runny nose, sore throat, cough, weakness, headache, low body temperature up to 37.5). A person begins to be treated independently, while only bringing down the body temperature, does not comply with bed rest and continues to work. And after a few days, there is a sharp rise in body temperature to high numbers, increased coughing, the appearance of pain in the chest, which indicates a complication of the process, the addition of a bacterial infection and the development of pneumonia. Therefore, it is better not to self-medicate, but to call a doctor to prescribe adequate therapy. If the doctor, when listening to the patient, hears wheezing or worsening of breathing on one side, then a chest x-ray is required to confirm pneumonia.

The symptoms of pneumonia in children depend on

• on the age of the child (which in turn indicates the perfection of the immune system),
• from the infectious agent
• on the extent of the process.

In children under one year old, the following signs can be detected:

• drowsiness,
• baby lethargy
• constant tearfulness,
• irritability;
• refusal of the mother's breast or artificial feeding;
• rise in body temperature (often to low numbers of 37.3-37.5 degrees);
• lag of one half of the chest in breathing;
• signs of respiratory failure - cyanosis of the fingertips and nasolabial triangle (may appear during feeding),
• baby's breathing.

In children older than 2 years, the clinical picture is similar to that in adults - an increase in body temperature to high numbers, weakness, drowsiness, sweating, loss of appetite, coughing up sputum. The child refuses the usual games. It is also possible to develop respiratory failure (increased breathing, pallor of the skin with a bluish tinge of the nasolabial triangle).

Pneumonia without fever

A latent form of pneumonia can occur without fever, but with characteristic signs. As a rule, it can appear after a cold, bronchitis or tracheitis, or in people with immunodeficiency. The main signs of pneumonia without fever:

• cough persists for more than 2 weeks;
• there is weakness and sweating, especially during physical exertion;
• pain when inhaling and coughing;
• a large amount of expectorant sputum or its absence;
• lack of mobility of one side of the chest;
• feeling of thirst;
• whistling breath.

Often the cause of pneumonia without symptoms is independent, without control of the regimen and duration of treatment. Such behavior only contributes to the subsidence of the inflammatory process, but not to recovery. At the same time, antibiotics further reduce their own immunity.

Pneumonia can occur without pronounced symptoms in cases where the immune system is severely weakened. This can be observed after a long illness, in the background of chronic diseases or surgery, as well as in people with HIV (human immunodeficiency virus), elderly patients and alcoholics. Most often, such pneumonia occurs after an acute respiratory viral infection, when the body temperature returned to normal, but severe weakness and sweating persist, decreased performance, when there is simply "no strength to get out of bed." Sometimes this condition may be accompanied by pain in the chest on the side of the lesion, a rare dry cough (which a person does not pay attention to at all or thinks that these are residual effects after SARS).

Forms of pneumonia

Classification of pneumonia

Inflammation of the lungs is a well-studied disease. It has an extensive classification. This allows you to better diagnose the disease, select effective therapy, predict the further course and develop preventive methods for patients. There are several main classifications of pneumonia.

Classification of pneumonia according to the condition of its occurrence

Of great importance for the treatment and prevention of the disease is an understanding of how the infection enters the lungs of the patient and what consequences this can lead to.

community-acquired pneumonia

One of the types of pneumonia, when the infection enters the respiratory tract by airborne droplets outside a hospital or other medical institution. Community-acquired pneumonia can be either viral or bacterial. Most often, the inflammatory process begins after a poorly cured flu, bronchitis, or tracheitis. Bacteria enter the lungs from the upper respiratory tract. With a weakened immune system, the body can not cope with new foci of inflammation. Pathogenic microorganisms settle in the lung tissue, causing acute pneumonia.

Often, patients with pneumonia have chronic diseases of the upper respiratory tract. In unfavorable seasons, when the immune system weakens, the inflammatory process starts again. With inadequate treatment of a chronic process, this can lead to the development of pneumonia.

Community-acquired pneumonia is relatively easy to treat with antibiotics. Since the bacteria that cause the disease are sensitive to most medicines. With timely diagnosis and treatment, the prognosis of the disease is quite positive.

Nosocomial pneumonia is an inflammation of the lungs that occurs 48 hours or more after the patient's hospitalization. Any medical institution is a kind of breeding ground for bacteria. And despite the implementation of sanitary and epidemiological measures, it is impossible to completely destroy the pathogenic microflora in them. Nosocomial infection is highly resistant to most antibiotics. Often, nosocomial pneumonia leads to death due to the difficulty in selecting effective antibiotic therapy. The following risk factors for the development of nosocomial pneumonia can be distinguished:

• unconsciousness
• elderly age
• tube feeding (this is feeding the patient through a special tube passed through the nose to the stomach when the patient himself cannot swallow, for example, with a stroke)
• horizontal position of the patient
• surgery and anesthesia
• chronic obstructive pulmonary disease (chronic disease with bronchial obstruction)
• long-term (more than 48 hours) IVL (artificial lung ventilation)

Aspiration pneumonia

Ingestion of the contents of the mouth, nasopharynx or stomach into the lower respiratory tract, in rare cases, solid particles (foreign body) can lead to the development of pneumonia and serious complications. This is primarily due to the fact that a foreign object (food, water, stomach contents, etc.) contains bacteria that can cause an inflammatory process.

The symptomatic picture of aspiration pneumonia is often blurred, since it mainly occurs in patients against the background of impaired consciousness (as a result of severe alcohol intoxication or traumatic brain injury), severe diseases of the nervous system (for example, stroke, impaired swallowing). And it develops gradually over one to two weeks.

A patient with pneumonia experiences weakness and a painful cough. More pronounced symptoms appear later in the form of purulent sputum with a characteristic odor, possibly mixed with blood, and a rise in body temperature.

With aspiration pneumonia, a fairly large part of the lung tissue is affected. A foreign body can interfere with sputum production, the bacterial flora develops, causing a purulent inflammatory process.

A patient with pneumonia requires special monitoring, timely diagnosis and treatment. In addition to antibiotic therapy, doctors are faced with the need to remove a foreign object, to carry out special procedures to cleanse the trachea and bronchi.

Unilateral pneumonia

This type of disease is characterized by the spread of the inflammatory process in the right or left lung, while only a small segment, an entire lobe or the entire lung field can be affected. Symptoms are pronounced or blurred, depending on the course of the disease. Timely diagnosis and treatment of pneumonia can avoid serious complications.

Bilateral pneumonia

In this case, the focus of inflammation is localized in the right and left lung, but does not necessarily affect the entire lung tissue. With bilateral pneumonia, a more severe and prolonged course of the inflammatory process is possible and signs of general intoxication of the body are more pronounced, but the principles of diagnosis and treatment in general do not differ.

Croupous pneumonia

A special form of pneumonia. With croupous pneumonia, the symptoms are pronounced:

• a strong increase in body temperature up to 40 degrees,
• dyspnea
• weakness
• secreted sputum has a reddish tint
• pain syndrome is pronounced

Inflammation often occurs in the whole lobe of one lung. The larger the focus of the inflammatory process, the more pronounced the symptoms.

Pneumonia in children, as in adults, can lead to airway obstruction and acute respiratory failure, pericarditis, lung abscess, sepsis, and even death.

Croupous pneumonia is most often caused by pneumococcus. And it is quite easy to treat with antibiotics of the penicillin series. Timely seeking help and adequate treatment will help to avoid complications.

Lobar pneumonia

If the localization of the inflammatory focus occurs in one lobe of the lung, then this is lobar pneumonia, in two lobes - bidoleic pneumonia. It can be unilateral or bilateral lobar pneumonia. Symptoms and treatment are identical with other types of pneumonia.

There are also forms of pneumonia, such as

• segmental (when a lung lobe segment is affected),
• total (when the entire lung field is affected)
• subtotal (when two lobes of the right lung are affected, since there are only two of them on the left - this will already be total pneumonia).

All these types of inflammation differ only in the prevalence of the inflammatory process. Symptoms intensify depending on the extent of damage to the organ. The more lung tissue is inflamed, the stronger they appear.

Depending on what caused pneumonia, further treatment of the patient is built.

Viral pneumonia

Quite often you can meet with a viral form of pneumonia. The onset of the disease is similar to the usual flu. Often, viral pneumonia develops during or after an acute respiratory viral infection or influenza. But at present, it is very difficult to diagnose which virus caused the inflammation, so antiviral drugs are used that act on most viruses.

They do not work on viruses. That is why a patient with pneumonia is prescribed antiviral drugs. Antibacterial therapy is possible in cases where the doctor suspects a secondary bacterial infection.

bacterial pneumonia

Bacteria are the most common cause of pneumonia. To date, such pneumonia has been successfully treated with antibiotics. But it is important to diagnose which bacterium caused the inflammation, and to choose a therapy based on the sensitivity of this bacterium to the antibiotic.

Mycoplasma pneumonia

A special type of pneumonia caused by the inhalation of a peculiar bacterium mycoplasma. The course of the disease is rarely severe. But the treatment is long. Most often, mycoplasmal pneumonia occurs in children and young people.

Chlamydial pneumonia

Most often occurs in children and adolescents. Less common in adults. Chlamydia enters the child's body from the mother if she had chlamydia. Chlamydial pneumonia develops gradually. At the initial stage, it is often confused with a cold. Treatment is selected individually, taking into account the age and individual characteristics of the organism.

fungal pneumonia

Caused by various types of fungi. The symptomatic picture can be blurred for a long time. Comprehensive diagnostics is necessary for statement of the diagnosis. Fungal pneumonia is not treated with antibiotics unless there is a secondary infection.

There are criteria for assessing the severity of pneumonia: find out how high the temperature, pulse, blood pressure; determine the general signs of intoxication and whether there are complications, as well as take into account the general blood test and the prevalence of the inflammatory focus. Depending on these signs, three degrees of severity are distinguished: mild, moderate and severe.

Light degree

For a mild degree of pneumonia, the following symptoms are characteristic:

• rise in body temperature to 38 degrees,
• at the same time, the level of blood pressure is within the normal range,
• pulse quickens according to temperature, but not more than 90 beats per minute,
• signs of intoxication are not pronounced (headache, weakness),
• skin of normal physiological color.
• The number of breaths up to 25 per minute.
• Complications are usually absent.
• In the general analysis of blood, a slight increase in leukocytes is noted.

It is quite easy to treat with one antibacterial drug, a quick positive effect occurs, without consequences. On the x-ray of the lungs, as a rule, a small focus of inflammation (segmental, focal pneumonia) is detected.

Average degree

With an average degree, the following symptoms are distinguished:

• rise in body temperature to 38-39 degrees, while the level of blood pressure may increase,
• pulse increases to 90-100 beats per minute,
• signs of intoxication are quite pronounced (headache, severe weakness),
• skin - moderate cyanosis (cyanosis) may appear.
• The number of breaths is 25-30 per minute.
• Complications appear in the form of pleurisy (inflammation of the pleura (the membrane around the lungs) with a small amount of fluid.
• In the general blood test, an increase in leukocytes and ESR (erythrocyte sedimentation rate) is noted.
• With this severity, an exacerbation of chronic diseases or worsening of their course (for example, coronary heart disease, exacerbation of bronchial asthma) is possible.

During treatment, it is possible to use several antibiotics at the same time. The duration of therapy, as a rule, increases to 2 weeks or more. On a chest x-ray, an inflammatory process of several segments of one or two lungs, up to an entire lobe, is revealed.

severe pneumonia

In severe pneumonia, the following manifestations are observed:

• rise in body temperature above 39 degrees, while the level of blood pressure may decrease (which indicates the development of infectious-toxic shock),
• pulse quickens and reaches 100 beats per minute,
• signs of intoxication are pronounced (severe headache, severe weakness, confusion or agitation, up to the development of coma),
• skin - pronounced cyanosis (cyanosis).
• The number of breaths / exhalations is more than 30 per minute.
• Complications may appear in the form of pleural empyema (purulent inflammation of the pleura), lung abscess (purulent destruction of lung tissue), infectious toxic shock.
• In the general blood test, there is a pronounced increase in leukocytes or their sharp decrease, toxic granularity of neutrophils, and a decrease in hemoglobin (anemia).
• In this case, heart failure, arrhythmias (abnormal heart rhythm), a sharp increase in blood sugar in patients with diabetes mellitus (which indicates a worsening of the course of chronic diseases) often occur.

Such patients need emergency treatment in the intensive care unit. In addition to antibiotics of various groups, detoxification therapy is necessarily used under round-the-clock supervision. Radiologically, it is more often bilateral subtotal or total pneumonia.

Causes of pneumonia

The microorganism enters the lung tissue through the upper respiratory tract, when inhaling, with a foreign body during aspiration or through medical equipment during manipulations (bronchoscopy, artificial ventilation, inhalation, etc.). Less common is the hematogenous route, that is, through the blood. This variant of infection is characteristic of intrauterine infection or with sepsis and drug addiction. Bacteria enter the lungs through the bloodstream and cause inflammation.

Adults may develop pneumonia if they have the following risk factors:

• the presence of an acute respiratory infection (ARVI, influenza) and hypothermia;
• chronic diseases of the upper and lower respiratory tract (rhinitis, bronchitis, tonsillitis, tracheitis);
• reduced immunity;
• elderly age;
• prolonged stay in a horizontal position;
• severe infectious diseases accompanied by a septic process;
• maintaining an unhealthy lifestyle: smoking, alcohol, drug addiction;
• surgical operations on the chest and abdomen
• oncological diseases (which lead to depletion of the body and immunity)
• treatment with drugs that lower the immune system (immunosuppressive therapy), such as glucocorticosteroids

The cause of pneumonia can be viruses, bacteria and fungi. The causative agents of community-acquired pneumonia are the following bacteria:

• pneumococci (most common)
• staphylococci,
• coli,
• haemophilus influenzae,
• klebsiella,
• as well as atypical bacteria (these are bacteria that live and multiply inside cells) that cause SARS - mycoplasma and chlamydia.

Viruses - adenovirus, influenza virus, cytomegalovirus, herpes virus. As for the fungal cause, it most often occurs in patients with severe immunodeficiency (in patients with HIV) - pneumocystis pneumonia, the causative agent of which is pneumocystis yeast-like fungi.

The causative agents of nosocomial pneumonia are microorganisms (most often bacteria) living in hospitals - this is Escherichia coli, Klebsiella, pneumococcus, Staphylococcus aureus .;

The cause of aspiration pneumonia is the microflora of the oropharynx, such as staphylococcus aureus.

The cause of pneumonia in children, as in adults, can be viruses, bacteria and fungi. The type of pathogen depends on the age of the child, the presence of risk factors, as well as the state of the immune system. For example, in children aged 6 months to 5 years, pneumococcus and Haemophilus influenzae are more likely to cause community-acquired pneumonia. In school-age children, the importance of an atypical bacterium, mycoplasma, increases, and in adolescents, chlamydia. Children under one year old and with reduced immunity may develop viral pneumonia (influenza virus, cytomegalovirus, herpes virus). Aspiration pneumonia can occur, for example, when a child spits up, more often the causative agents of such pneumonia are Escherichia coli, Staphylococcus aureus.

In school-age children, pneumonia can occur if the following risk factors are present:

• chronic infectious diseases of the nasopharynx;
• frequent bronchitis;
• acquired pathologies of the heart;
• genetic diseases;
• diseases of the immune system;
• smoking.

Causes of pneumonia in newborns

One of the most common acute infectious diseases in newborns is pneumonia. The frequency of occurrence, according to various data, varies from 10-15% in premature babies, 1% in full-term babies. There are 2 ways of developing pneumonia in newborns:

• bronchogenic - when the infection enters directly through the upper respiratory tract, through the bronchi into the lungs;
• hematogenous route - infection through the blood from mother to child.

Infection can occur in the following ways:

• through the placenta to the fetus (hematogenous route) - it can be both bacteria - toxoplasma, and viruses - herpes virus
• through the amniotic fluid, more often pathogens are bacteria (streptococcus, mycoplasma, Haemophilus influenzae).
• during birth (when passing through the birth canal) - in this case it can be streptococcus, chlamydia, genital herpes, cytomegalovirus, fungi.
• after birth (hospital-acquired pneumonia caused by Klebsiella, Pseudomonas aeruginosa, staphylococcus aureus, E. coli, Proteus, or maternal infection)

You can also highlight the risk factors that contribute to the occurrence of pneumonia in newborns:

• intrauterine oxygen starvation (asphyxia and hypoxia);
• intrauterine infection of the fetus
• birth trauma;
• malformations of the heart and lungs;
• immunodeficiency;
• beriberi;
• malnutrition in children causing malnutrition
• premature babies

Diagnosis of pneumonia

The diagnosis of "pneumonia" is made on the basis of the clinical picture, and a number of instrumental and laboratory studies. The diagnostic procedures carried out will help the doctor to make the correct diagnosis and prescribe adequate treatment. Currently, the gold standard for diagnosing pneumonia is chest X-ray.

X-ray examination of the lungs allows you to determine in which part of the lung the inflammatory process is taking place, how extensive the damage to the lung tissue, etc. There are no strict contraindications for the study. An exception is pregnancy, but in extreme cases, when the condition threatens the life of the mother and child, it is also carried out during pregnancy.

Microscopic examination of sputum allows you to identify the causative agent of the disease, obtain information about the stage of the inflammatory process, and helps in the selection of drugs.

Sputum culture helps not only to isolate the pathogen, but also to choose an effective antibacterial drug for treatment.

A clinical blood test shows the presence of an inflammatory process and helps determine the severity of the disease. An important indicator is an increase in leukocytes in the blood and a shift in the leukocyte formula.

A biochemical blood test allows you to evaluate the overall work of internal organs and timely identify possible complications.

The study of the gas composition of the blood gives a general picture of the filling of the body with oxygen. With pneumonia, especially in severe form, you can see insufficient oxygenation of the blood.

Laboratory research methods, as well as listening to wheezing in the lungs, measuring the number of respiratory movements, pulse and blood pressure help to assess the general condition of a patient with pneumonia.

Additional diagnostic methods

Due to the fact that pneumonia can be of different types, there are additional diagnostic methods:

• Computed tomography of the chest gives a clearer picture of the condition of the lungs and may indicate possible complications.
• A biopsy of the pleura and lung allows you to determine the degree of tissue change under the influence of the inflammatory process.
• Bronchoscopy allows not only to visually look at the condition of the larynx and bronchi. With the help of the device, you can remove a foreign body, inject a medicinal solution, evacuate viscous sputum and take a biopsy (a piece of tissue) if necessary.
• Blood cultures are done in the case of a severe course of the disease to identify the pathogen when the bacterium from the lungs enters the bloodstream and sepsis begins. This analysis allows, firstly, to confirm such a serious complication as sepsis and to determine the sensitivity of this bacterium to antibiotics.

Pneumonia is treated mainly in a hospital under the supervision of a doctor. This helps to avoid the development of the disease and subsequent complications. Uncomplicated acute pneumonia is treated within 10-14 days. The aftercare process takes place already at home, subject to all medical recommendations.

Severe forms of pneumonia require longer treatment. With this type of disease, additional diagnostic methods are often used. Treatment is often carried out in intensive care units and intensive care units. This allows you to keep the patient's condition under additional control and, if necessary, provide emergency assistance.

Treatment of pneumonia is prescribed by a doctor, after carrying out the necessary diagnostic measures. Based on the varieties of the pathogen and the characteristics of the course of the disease, the treatment is selected individually. The doctor, making appointments, focuses on the overall picture of the disease, the symptoms and the physical condition of the patient.

Treatment of pneumonia in an adult

Treatment of mild pneumonia can be carried out on an outpatient basis (that is, at home) under the supervision of a local therapist and under the control of a chest x-ray. Treatment of moderate and severe, as well as pneumonia in children and the elderly, if the patient has concomitant serious diseases, should be carried out only in a hospital.

From the moment the diagnosis was made, the patient is prescribed broad-spectrum antibiotic therapy, regardless of the causative agent of the disease. This is due to the fact that laboratory diagnosis takes time. And the first medicines are selected by trial method. After the diagnosis, the treatment is built according to the following criteria:

• appearance condition: community-acquired, nosocomial, aspiration;
• volume of lung damage: unilateral, bilateral, lobar, or others;
• cause of occurrence: virus, bacteria, etc.;
• flow form: mild, moderate or severe;
• general condition of the patient, age, severity of symptoms;
• the presence of concomitant diseases of the heart, lungs, kidneys.

Treatment of pneumonia is divided into the main, aimed at destroying the source of inflammation, and symptomatic - pain relief, expectorant drugs, antipyretics. Inhalations and physiotherapy measures are often used.

The main treatment depends on the pathogen - if viral pneumonia is suspected, then antiviral drugs (tamiflu, ingaverin, arbidol) are prescribed. If bacterial, then broad-spectrum antibiotics (cephalosporins, fluoroquinolones, macrolides).

After the type of pathogen is established (which does not happen often), the antibiotic can be replaced according to the sensitivity of this bacterium to it. It should also be remembered that against the background of ongoing treatment, the patient's condition should improve. If within three days of antibiotic treatment the body temperature does not decrease, the symptoms of intoxication do not decrease, then the antibiotic should be replaced. Symptomatic treatment includes drugs that make the patient feel better:

• antipyretic (paracetamol, nurofen, ibuprofen, lytic mixture - analgin + diphenhydramine + novocaine). As for body temperature, it is worth reducing it only at 38 degrees and above. The temperature below 38 degrees does not need to be reduced, as this is a sign of the inclusion of a protective reaction of the immune system.
• painkillers (for chest pain) - ketonal, diclofenac
• expectorant and mucolytic drugs (thinn sputum and facilitate its discharge) - mukaltin, bromhexine, halixol, ACC (acetylcysteine)
• cough suppressants (with a painful and dry cough) - sinekod, libexin.

Physiotherapy (magnetotherapy, electrophoresis on the focus of inflammation, inhalation) is prescribed only when the body temperature is normalized.

As with any infectious process, with pneumonia, bed rest must be observed. It is very important to consume a large amount of fluid (2.5-3 liters, in the absence of contraindications). If the patient is treated in a hospital, then infusion therapy is usually prescribed (intravenous administration of various solutions - glucose, saline solutions, vitamins). With adequate, timely prescribed therapy, pneumonia is completely eliminated.

Just like in adults, the treatment of pneumonia in children is carried out in two directions - they affect the source of inflammation and the general condition of the patient. Symptomatic therapy will allow the child to feel better, lower the temperature, make breathing easier, and reduce coughing. Antibacterial therapy is aimed at destroying the inflammatory process.

Children under 3 years of age with pneumonia must be hospitalized. Older children, with mild pneumonia, can be treated at home (under the supervision of a pediatrician).

Just like in adults, broad-spectrum antibiotics are prescribed. More often it is the penicillin group (ampicillin, amoxiclav, amoxicillin), cephalosporins of different generations (cefuroxime, ceftriaxone), macrolides (azithromycin). In severe cases, several groups of antibiotics are combined or antibiotics are combined with antimicrobials (for example, metronidazole, sulfonamides).

The effectiveness of treatment is evaluated within three days (decrease in body temperature, decrease in symptoms of intoxication, the appearance of appetite, the child becomes more active). If it is not effective, the antibiotic is changed. It is important to prescribe probiotics (bifiform, hilak forte, linex) to protect the intestines, since massive antibiotic therapy may disrupt the intestinal microflora and cause diarrhea.

Be sure to observe bed rest for a period of high temperature, drink plenty of water. Expectorant and mucolytic (sputum-thinning) drugs are also prescribed - Doctor Mom, bronchicum, fluimucil. At a temperature of more than 38 degrees - antipyretic (nurofen, panadol).

In the acute form of pneumonia, treatment is based on antibiotic therapy. The effectiveness of the antibiotic can be seen already for 2-3 days. Intoxication is reduced, symptoms are relieved. If on the third day the patient's condition does not improve, the doctor replaces the antibiotic.

The effectiveness of antibiotics for pneumonia depends on the infection that caused the inflammatory process. There are drugs with a wide spectrum of action. They are most often used in hospitals. But there are antibiotics designed to kill certain bacteria. It is for this that patients undergo diagnostics to identify the pathogenic microflora that caused the inflammatory process.

Groups of antibiotics used to treat pneumonia:

• Penicillins.

At this point in time, there is a sufficient number of antibiotics of the penicillin series. These can be synthetic antibiotics or combined. Some antibiotics of this group can be used during pregnancy, but under the strict supervision of a gynecologist.

• Tetracyclines.

At the moment, they are not often used in medicine. This is due to the resistance of most infections to the drug. Also, this series of antibiotics is not desirable for use during pregnancy, breastfeeding. The drugs are not used to treat children and people with kidney disease.

• Cephalosporins.

It has been successfully used in the treatment of pneumonia. This is especially true of fourth-generation cephalosporins. It has been successfully used to treat pneumonia in children.

• Macrolides.

No less effective in the treatment of pneumonia. Can be used to treat pneumonia in children. There are contraindications for use for people with liver pathology.

• Aminoglycosides.

They are prescribed for pneumonia in cases where combination antibiotic therapy is required.

• Fluoroquinolones.

This group of drugs also successfully copes with pneumonia. But there are contraindications: pregnancy and children under 18 years of age.

Treatment of Community Acquired Pneumonia

Community-acquired pneumonia requires complex treatment. Drug therapy is aimed at combating the inflammatory process and at relieving symptoms. The following groups of drugs are prescribed:

• antibiotics for pneumonia - help to cope with the infection that caused the inflammatory process in the lungs;
• painkillers and antipyretics - used to relieve high body temperature and pain. For these measures, analgesics (analgin, baralgin, no-shpa, etc.), paracetamol, and non-steroidal anti-inflammatory drugs (NSAIDs) are used. The last group of drugs (NSAIDs) should be used with extreme caution. There are contraindications for patients with diseases of the gastrointestinal tract.
• mucolytic agents - contribute to the thinning and discharge of sputum from the lungs, these include mukaltin, ACC, etc .;
• bronchodilators - relieve spasm in the bronchi, facilitate the discharge of sputum, help with shortness of breath. These are eufillin, theophylline, etc.;
• immunostimulants - drugs that help restore and maintain the immune system;
• multivitamins - make up for the deficiency of vitamins in the body, help maintain the immune system and the functioning of internal organs.

Treatment of viral pneumonia

Viral pneumonia is treated in the same way as bacterial pneumonia, only antiviral drugs are the main remedy:

• ingaverin
• Tamiflu
• arbidol
• acyclovir
• valaciclovir etc.

Antiviral drugs for pneumonia are prescribed depending on the virus that caused the disease.

Treatment of pneumonia with folk remedies

Pneumonia is a very serious disease and requires complex treatment. In addition to modern methods of antibacterial and symptomatic treatment, there are alternative methods that can help relieve symptoms.

However, any folk methods can only act as an adjunct therapy to the main treatment. They are by no means a substitute for the use of antibiotics or antiviral drugs.

With pneumonia, treatment with folk remedies includes herbal preparations, wiping, warming up (provided that there is no high temperature), inhalation. The following fees are currently in use:

• Breast collection, several types
• Phytopectol No. 2;

Honey and honey-based products help to lower the temperature, stimulate the work of the whole organism, including the immune system. Also, honey compresses are used in the area between the shoulder blades. This creates heat, promotes the expansion of the bronchi, facilitates breathing and sputum discharge.

During the inflammatory process, intoxication of the whole organism occurs. In order for toxins to be removed from the body faster, a patient with pneumonia must be provided with plenty of fluids, up to three liters per day.

Inhalations in the treatment of pneumonia are best done when the acute condition has passed. For this procedure, you can use a variety of natural substances and herbs:

• honey has an anti-inflammatory effect;
• propolis enhances the immune system;
• medicinal plants (peppermint, sage, calendula, chamomile, oregano, eucalyptus) - reduce swelling of the mucosa, improve breathing.
• Kalanchoe - has anti-inflammatory and antiviral properties.

At home, pneumonia is treated in cases where there is no danger to human life. An acute inflammatory disease, without complications with a normal course of the disease, detected in time, requires certain care:

• plentiful drink;
• balanced diet;
• bed rest;
• airing the room 2 times a day;
• change of underwear and bed linen with heavy sweating;
• if necessary, help the patient change position in bed so that there is no stagnation in the lungs (especially for children and the elderly).

Otherwise, when treating pneumonia at home, it is important to strictly follow the doctor's recommendations and take the prescribed medications in a timely manner. It is important to remember that it is strictly forbidden to cancel the prescribed antibiotics or antiviral drugs or change the dosage on your own, even if the patient quickly felt improvement and it seems to him that he is completely healthy. A temporary reduction in symptoms does not always mean recovery.

It is not permissible to self-medicate and try to cope with the disease only with folk remedies. Inadequate treatment is dangerous with serious complications up to death.

Pneumonia without treatment

Pneumonia is quite a dangerous disease. Delay in treatment can lead to serious consequences. First of all, lung tissue suffers. Purulent inflammations can begin in it, which lead to even greater damage to the lungs, which can cause oxygen starvation in the body. With complicated pneumonia, the lungs cannot fully perform their functions. Violation of oxygen metabolism will affect the cells of the whole organism. Infection without proper treatment can spread to nearby organs. Most often, the heart suffers. And the entry of bacteria into the blood can lead to sepsis. The worst option for pneumonia left without proper treatment is the death of the patient.

Patient with pneumonia. Features of care

With any disease, proper care is half the healing process. Pneumonia is no exception to this rule. The main features of caring for a patient with pneumonia:

• Bed rest.

It includes the rest of the patient. But this does not mean that a person should lie motionless in bed. It is very important to change position. This will help to avoid stagnation of fluid in the lungs. The semi-sitting position will make breathing easier. Coughing will help expel mucus. When caring for the elderly and children, it is important to help them change positions in bed.

• Plentiful drink.

When the bacteria are destroyed, toxins are released into the blood, which leads to intoxication of the body. In order to alleviate the patient's condition, purify the blood and remove intoxication, a constant supply of fluid to the body is necessary. Also, patients lose a lot of fluid with sweating, during an increase in body temperature. It is to restore the water balance in the body and remove toxins in hospitals that solutions are administered intravenously. During acute inflammatory processes, doctors recommend drinking plenty of water, up to 3 liters per day.

• Access to fresh air and ventilation of the room.

Indoors, there is less oxygen and more carbon dioxide. A patient with pneumonia already suffers from a lack of oxygen in the body. Also, when the patient coughs, bacteria is released. This can negatively affect the health of loved ones and those around them. That is why you should ventilate the room at least 2 times a day.

• Balanced diet.

During an acute inflammatory process, the body is weakened and you should not load it with heavy food. Food should contain proteins that are easy to digest - such products include lean boiled chicken, turkey, and beef. And fortified plant foods - fruits with vitamin C content and vegetables. In acute pneumonia, spicy, salty and fatty foods should be avoided.

• Change of underwear and bed linen.

Acute pneumonia often occurs with profuse sweating. For the comfort of the patient himself and reclining hypothermia, bed and underwear should be changed in a timely manner.

• Control over the intake of drugs.

Medicines such as antibiotics should be drunk strictly by the hour, observing the temporal cycle. That is why the patient's relatives have to control the timely intake of medicines.

Pneumonia is a serious disease. The lack of timely treatment or adequate therapy can adversely affect both the lungs and the body as a whole. Complications of pneumonia are varied and can be life-threatening.

Complications of pneumonia in adults

Inflammation of the lungs with poor-quality or untimely treatment leaves an imprint not only on the respiratory organs and the nearby heart. It also affects other organs:

• Destruction of lung tissue.

Due to a strong inflammatory process, the affected tissues are destroyed, creating cavities in the lungs. These cavities tend to fester, releasing not only toxins, but also pus into the blood. The result of this decay is sepsis.

• Severe swelling of the bronchi.

Inflammation of the tissue is accompanied by edema, due to which the bronchial path narrows. This leads to impaired respiration and oxygen metabolism, and, consequently, to oxygen starvation of all body cells. This process can lead to the pathology of all human organs.

• Pleurisy.

This is an inflammation of the lining of the lung. The patient feels this disease as pain in the chest during a deep breath.

• Pulmonary edema.

In this case, fluid accumulates in the lung tissue, which leads to respiratory failure.

• Heart failure.

The heart is the closest organ to the lung. And during complications suffers one of the first. Due to the fact that there is not enough oxygen in the body, the heart is forced to pump blood even faster so that the cells of the body are filled with crumbs of much-needed gas. All this leads to the fact that the heart muscle does not cope with the work and heart failure occurs.

• Infectious-toxic shock.

With this complication, the patient is in an extremely serious condition, up to coma. Mortality in intoxication shock is extremely high.

• Blood clotting disorders.

This complication can lead to bleeding in any organs.

• Psychoses.

Psychotic disorders can manifest themselves due to severe toxic shock and oxygen starvation of brain cells.

Pneumonia, if it is a truly acute inflammatory process, and not some other disease (for example, lung cancer with the formation of pneumonia), with timely adequate treatment, is always successfully cured. But sometimes it can lead to the formation of foci of fibrosis in the lung tissue (the appearance of connective tissue at the site where there was inflammation), which can clinically manifest as shortness of breath.

Complications of pneumonia in children

The picture of complications in pneumonia in children is exactly the same as in an adult. Violation of the internal organs during acute inflammation can lead to serious complications up to death.

Complications of pneumonia in children can be divided into two groups: pulmonary (developing in the lungs) and extrapulmonary (developing outside the pulmonary system).

Pulmonary:

• pleurisy (inflammation of the pleura),
• abscess and destruction of the lung,
• pneumothorax (air entering the chest)
• respiratory failure (the appearance of shortness of breath - an increase in the frequency of breathing,
• pallor of the skin with a bluish nasolabial triangle,
• increased heart rate)
• pleural empyema (purulent inflammation of the pleura).

Extrapulmonary:

• toxic shock,
• DIC (disseminated intravascular coagulation syndrome, when the balance between the coagulation and anticoagulation system of the blood is disturbed, diffuse bleeding begins),
• RDS syndrome (respiratory distress syndrome - occurs due to edema and inflammation of the lungs, while the function of gas exchange and oxygen saturation of the body is disturbed),
• sepsis (spread of infection through the blood throughout the body),
• neurotoxicosis (damage to the nervous system due to severe intoxication).

The best cure for pneumonia is prevention. A healthy body with a strong immune system can fight almost any infection.

Prevention of pneumonia in adults

• Maintaining immunity. To do this, it is important to follow a number of simple rules:
  • balanced nutrition with a sufficient amount of proteins, carbohydrates, amino acids, vitamins, microelements valuable for the body;
  • drinking water helps the body cleanse itself of excess toxins that constantly enter the body;
  • absence of bad habits such as smoking, drug addiction, excessive alcohol consumption;
  • physical activity promotes blood circulation, reduces the likelihood of congestion in the body;
  • hardening;
  • the use of fortified preparations, especially during periods of beriberi (late winter and spring);
• Avoid hypothermia. It is very important to dress according to the weather so that the body is warm.
• Room ventilation. Fresh air will clean the room from excess carbon dioxide.
• Timely treatment of colds.
• The use of medical masks during an influenza epidemic and in crowded places of sick people.
• Hygiene. No one canceled the systematic washing of hands before eating. Personal hygiene helps to avoid some diseases.
• Influenza vaccination during an epidemic.

Prevention of pneumonia in children

Preventive actions for children and for adults are similar to each other. But it is worth adding a few points to children's prevention.

• Timely vaccination of children according to the schedule. This is monitored by pediatricians, and they are required to report when the next vaccination of the child will be carried out.
• Prevention of colds and viral diseases. Young children should not be in social institutions during epidemics. This applies primarily to medical institutions. Nosocomial infections are more difficult to treat. Don't put your child at risk.
• Timely treat a cold at home. If the child is sick, then visits to kindergartens, schools, clubs and other educational, sports and entertainment centers should be canceled until complete recovery. The child's immune system is not yet strong enough and should not be exposed to additional risks.
• Wet cleaning of the room, ventilation, body hygiene are important components of prevention.
• Daily outdoor activities.

Careful monitoring of the child's condition by the parents. Change in behavior, apathy, anxiety can be a sign of the onset of the disease. Timely diagnosis and treatment will help to avoid an acute form of pneumonia in children and unwanted complications.

Mothers are afraid to infect the baby, to harm him with the medications they take. And some immediately stop feeding ... is it all right? it is necessary to discuss this issue in detail and in detail.

A few criticisms

Very often, illnesses of the mother during breastfeeding are perceived as almost the end of the world, a common cold is a serious illness and they immediately stop breastfeeding the baby. This is a very wrong and dangerous position.

In fact, there are not so many real situations when breastfeeding should be stopped temporarily or permanently. And these are usually very serious and serious illnesses, to which banal colds and even pneumonia do not belong. Most of the common and common diseases of lactating women do not require the termination of breastfeeding, it continues in the usual mode for a woman with active treatment of the mother herself. In rare cases, feeding from the breast itself is temporarily stopped, the breast is expressed, and the expressed milk is given to the child from their spoon or special supplementary feeding systems.

Often there are situations when specialist doctors, to whom a nursing mother turns for treatment, simply cannot, due to lack of experience and knowledge in breastfeeding, advise anything really correct, they simply forbid a woman to breastfeed. But a doctor who really supports breastfeeding will always be able to find real ways to solve the problem of breastfeeding for each specific illness of a nursing mother. In order not to have to stop breastfeeding, according to special reference books, you can choose drugs that are fully compatible with breastfeeding. In treatment, there is almost never such a situation that only one drug is applicable. You can always find safer analogues with a similar effect, in which you can safely breastfeed.

What's in the instructions?

Often, in the usual pharmaceutical reference books and in the annotations to medicines, the column “use during pregnancy and lactation” writes a ban on use due to the lack of knowledge of the issue. Some reference books write - "use with caution if the potential benefit to the mother outweighs the risk to the baby," which is very frightening for women with this formulation.

However, this will not mean at all that this medicine of a nursing mother cannot be used for treatment. It is very difficult to simply obtain official approval for the use of the drug in lactating women, it is necessary to conduct global mass studies of the drug on lactating female volunteers and their children. And it is very troublesome and very expensive. Pharmaceutical campaigns do not need such a practice and waste of money - it is easier for them in such cases to set a ban in the instructions for the drug and not rack their brains.

Usually in practice, most of these drugs are quite acceptable for use during lactation and lactation consultants have many years of development in this matter. In the world, in addition to consulting experience, there are also scientific developments and research of drugs under the auspices of WHO or other independent organizations, whose opinion cannot be influenced by various commercial companies. The scientific laboratories of these associations conduct research on drugs for breastfeeding mothers and their babies, and these experts give an independent verdict on each specific drug. In reality, in practice, not a very large number of drugs are actually not allowed to be taken by nursing mothers.

If you have any doubts about whether it is possible to take this or that medicine, you can contact consultants for help and advice on the use of these drugs during the feeding period.

What diseases are serious?

In most cases, we are talking about the usual ordinary colds of a viral nature, however. Almost all breastfeeding mothers believe that if they breastfeed their child, they will definitely harm him by infecting him with their disease. And therefore, it urgently needs to be weaned and transferred to the mixture. The position is very wrong. In addition, mothers diligently put on a mask when communicating with a child and boil expressed breast milk before feeding in order to infect their child also through milk. However, this is the exact opposite of what is necessary. Naturally, if the mother sneezes every 5 minutes and coughs regularly, you can wear a mask to reduce virus contamination (or you can not wear it and use a scarf). However, every disease has an incubation period during which the woman is already contagious, but she does not yet show signs of the disease.

So, by the time the mother has all the signs of the disease, she has either already infected the baby, and he also fell ill and the clinic will appear later. Or he received antibodies to her disease with her milk and will not get sick at all.

When you can and can't

Let's discuss the most common diseases and feeding issues for these diseases, whether it is possible or not to feed with them, and how breastfeeding mothers can be treated with them.

Any form of chlamydial infection in the mother does not imply the termination of breastfeeding, it is carried out without any special features. In the case of the development of genital forms, it is worth limiting to local treatment. And if it is a general or pulmonary form, it is necessary to use special antibiotics that are compatible with breastfeeding.

If a mother is diagnosed with hepatitis A (Botkin's disease), she is not forbidden to feed. But it is necessary to observe strict hygiene measures and introduce a special anti-hepatitis immunoglobulin to the child, which will protect the baby from possible infection.

If a mother has hepatitis B, breastfeeding is not prohibited and is carried out as usual, however, the baby will immediately be given a special immunoglobulin for the hepatitis B virus in a special dose after birth, and vaccinated against hepatitis B according to a special scheme - immediately after birth, at one and six months and at one year old.

If a woman has a herpes infection anywhere on her body, genitals, or lips, breastfeeding is not prohibited. But it is required to comply with all hygiene measures with frequent washing of hands, if there are rashes on the face, do not kiss the child at all until the crusts fall off. The same is true for shingles - it's one of the herpes infections, and it's contagious - if a child gets infected, he'll get chickenpox. Temporarily stop feeding from the affected breast if herpes is on the skin near the nipple or on the nipple.

If a mother has sexually transmitted infections - syphilis or gonorrhea, if the mother is treated correctly and quickly, breastfeeding is not prohibited. However, if the mother became infected with syphilis at 6-7 months of pregnancy and later, and the baby was born healthy, then breastfeeding is prohibited, it is recommended to feed with donor milk (nurse).

With the development of the so-called "childhood infections" in the mother - measles, rubella, chicken pox, mumps, breastfeeding is not prohibited, but sometimes the doctor may recommend the introduction of special anti-infectious (for each disease separately) immunoglobulins to the child.

If the mother has developed one of such serious and dangerous diseases as dysentery, typhoid fever or salmonellosis, and in addition. with chronic hepatitis, the mother can give the baby expressed and sterilized breast milk from special systems for supplementary feeding.

With SARS, pneumonia, bronchitis, otitis media, tracheitis and laryngitis, a child can and should be breastfed if you feel well and your condition allows it, these diseases are not a contraindication to breastfeeding. It is only necessary to observe basic hygiene measures - washing hands, using handkerchiefs and wearing a mask if you are very afraid of infecting.

If the mother develops acute intestinal infections of a viral or bacterial nature, if the mother is in a satisfactory condition, breastfeeding can be observed, again, with basic hygiene measures.

With the development of mastitis and lactostasis in a woman, breastfeeding is not something that cannot be stopped, it is one of the treatment measures - regular emptying of the breast and creating an outflow is a way to cure lactostasis and mastitis. Therefore, under these conditions, breastfeeding continues as before. Only if there is an abscess in the chest and pus is separated in a mixture with milk, it is possible to stop feeding from the affected breast for a while, however, they do not stop feeding with a healthy gland. At the same time, mommy is treated according to all the rules for managing mastitis - if necessary, they will make an incision and drainage. Antibiotics are prescribed those that are compatible with breastfeeding.

When not to

Temporary or permanent contraindications in the health of the mother, in which, alas, it is impossible to feed, this is the formation of eclampsia during childbirth, severe bleeding during childbirth and postpartum, open forms of tuberculosis, severe disorders of cardiac, renal and pulmonary activity, when a woman after childbirth is physically unable to feeding due to a general severe condition. Another contraindication will be a severe form of hyperthyroidism with the use of large doses of cytostatics, acute mental illness of the mother, when it is dangerous for the child. In addition, the ban on feeding occurs with HIV. But hepatitis B and C are not a contraindication to breastfeeding, sometimes it is recommended to feed through special silicone pads.

What about drugs?

We have already mentioned that during breastfeeding, the use of most of the known drugs is acceptable, especially for short-term use. However, when taking medications, reasonableness and an approach are needed in terms of harm and benefit for both - mother and baby. For the most part, in acute diseases, a minimum of drugs is applicable and their course is short, they will not harm the child. But when long-term treatment of chronic pathology of the mother is required, then the issue becomes more serious. Counts. That if the mother was able to keep the pregnancy and give birth, then breastfeeding would not be a problem. But here is a list of medicines you need to choose like this. to make it compatible with breastfeeding, or to discuss the issues of withdrawing some of the drugs and replacing them with other types of treatment - local or drug-free.

Medicines are allowed for the usual methods of use - paracetamol and nurofen, be careful with analgin and aspirin, but you can take them once - this is not dangerous. You can use all antitussives except codeine. In addition, a large group of antibiotics can be used - penicillins, cephalosporins, erythromycins and others. Even many anti-tuberculosis drugs are possible. antifungal agents are allowed, except for fluconazole, griseofulvin, ketoconazole, itraconazole, although they can also be applied topically.

When using drugs with hormones, lactation can be suppressed, which must be taken into account when using them.

It is impossible when feeding:

Cytostatics (for the treatment of severe allergies and oncology)

immunosuppressive agents,

anticoagulants,

radioisotopes,

X-ray contrasts,

lithium drugs,

drugs against worms,

Almost all antivirals, except for acyclovir, zidovudine, oseltamivir.

No tetracyclines

macrolides,

Fluorohimnolones and co-trimaxazole.

For viral infections, antipyretics and plenty of fluids are indicated, you can drip fluferon, interferon, or insert viferon suppositories. All drugs for the treatment of cold symptoms can be used without fear - they are allowed when breastfeeding, if possible, traditional medicine should be widely used, well, within reason, of course.

Due to weakened immunity, constant stress, lack of sleep, postpartum depression and a number of other reasons, pneumonia can also begin in a patient during lactation.

Main antecedents:

• In the case when a young mother froze, wet her feet, caught a cold due to hypothermia.
• Weakened immunity
• The occurrence of a viral infection.
• Alcohol consumption.
• The ingestion of pathogens such as staphylococci, pneumocystis, Klebsiella and other bacterial microorganisms.

As for pathogens, pneumococci, staphylococcus, Klebsiella bacteria are considered the main ones, in the presence of the pneumocystis immunodeficiency virus and a number of other variants of bacteria.

According to the peculiarities of the postpartum period, as a rule, of the listed reasons, the most frequent is the failure of immunity. Due to a change in the daily regimen, worries about the baby and accumulated fatigue, a young mother can suddenly become ill with pneumonia. Sometimes for this it is enough to sit by the air conditioner and catch a cold, communicate with a sick person or not cure bronchitis.

Symptoms

• Lethargy, increased sweating, refusal to eat due to poor appetite.
• Body temperature rises sharply. It can reach 40 degrees.
• The head constantly hurts, the state of health worsens by night.
• The occurrence of attacks of fever in the acute form of the disease.
• Unproductive, cough that can torment even in sleep. At first without expectoration, then becomes more moist.
• Feeling of discomfort in the muscles of the limbs.
• When breathing, the patient and others hear wheezing, gurgling, whistling.
• Shortness of breath when walking, often respiratory failure.
• Pain in the abdomen, gastrointestinal disorders

Diagnosis of pneumonia in nursing

Diagnostics is carried out in the following order:

• First, the doctor examines the patient.
• Clarifies the condition of the larynx, listens to how the patient breathes, asks about other symptoms of the disease.
• It is important for the doctor in the first minutes to understand how serious the problem is in order to know how to eliminate it.
• The doctor takes into account the data of the anamnesis, therefore, asks about the diseases that the patient has had. This is sometimes of fundamental importance for further treatment tactics.
• Orders a complete blood count. Blood is examined for biochemistry.
• Bronchial secretion analysis.
• Performs fiberoptic bronchoscopy, if necessary.
• With the course of the disease in severe form, sputum is taken.

Complications

The consequences of the disease can be very different: from the development of chronic and irreversible pathologies to death.

The patient must understand that pneumonia is not a common cold. The disease will not go away on its own. It needs to be treated, and for this, measures should be taken in combination.

Another mistake many people make is self-medication. In addition to an experienced specialist, no one will correctly prescribe a treatment regimen, the physician will determine the therapy based on the results of the tests.

Development of acute pleurisy.

One of the sections of the lung begins to fester.

Acute respiratory failure, in which attacks of suffocation are observed.

This also includes bronchial obstruction with similar symptoms.

Inflammatory process in the brain, which affects the physical and mental activity of the patient.

Development of extreme emaciation aggravated by acute anemia.

The ingress of toxins into all organs and tissues, which serves to cause a state of shock.

Treatment

What can you do

At the time of treatment, feeding should be abandoned so that the medications taken during therapy do not harm the child. In order not to lose milk, during the period of refusal to feed, one should express, then the lactation function will continue.

What does a doctor do

The doctor, examining the patient, determines the treatment regimen, taking into account that the patient is breastfeeding. But if the disease is severe, the doctor warns that the medications he prescribes are not compatible with feeding, and breastfeeding should be abandoned during treatment. The specialist may prescribe the following medications:

• Medicines that allow you to remove sputum and enhance the process of expectoration. It is necessary to avoid the accumulation of sputum and its collection in the respiratory organs.
• Different kinds of inhalations are prescribed. A list of certain drugs is also attached by the doctor. Here, the doctor takes into account the lactation period and warns the nursing mother whether it is possible to breastfeed during this period or whether to refrain from breastfeeding.
• Antibiotics. The chemicals contained in these medicines can adversely affect the condition of the baby. Therefore, during the period of taking antibiotics, the specialist urges to refuse feeding.
• In the most severe cases, an operation is indicated, for which special preparation is required.
• Against the temperature, rectal suppositories with antipyretic action are prescribed.
• They can connect to the artificial respiration apparatus in case of severe pathological processes in the lungs.

Prevention

To prevent such a serious illness, you need to be careful about your health. After childbirth, a young mother is more susceptible to various diseases than ever. Her body is under stress after such a shock as childbirth. A nursing mother needs to think not only about the health of the baby, but also about her own. After all, a baby needs a healthy strong mother. You should carefully look at the daily routine and some household duties, not embarrassed to shift onto the shoulders of loved ones, if possible. Since fatigue can accumulate in the body and, as a result, a serious malfunction of the body occurs, which can lead to pneumonia and other pathologies.

• In addition, you need to take vitamins.
• Food should be complete and high-calorie.
• You should also beware of hypothermia.
• During an unfavorable epidemiological situation, a mask should be worn.
• Treat colds in time and not let health problems take their course.

Pneumonia is an inflammation of the lung tissue, the causes of which can be completely different microorganisms - viruses, bacteria, protozoa. Most often, the disease occurs during periods of weakened immunity: in chronic diseases, in the elderly and childhood, as well as after childbirth. Why is pneumonia dangerous for a nursing mother? How to suspect an illness, quickly and safely for yourself and your baby to recover?

Read in this article

Why pneumonia is dangerous for a young mother

The lungs are one of the most important organs in the human body, they are responsible for gas exchange. It is here that red blood cells give off carbon dioxide, and in return they receive oxygen, which they carry to all tissues.

Inflammation of the lungs leads to respiratory failure of varying severity, which affects the general well-being of a woman and can even lead to death.

In most cases, against the background of adequate treatment, pneumonia disappears without a trace. Certain types (for example, with influenza) can lead to a serious condition with hospitalization in intensive care and artificial ventilation of the lungs.

Improper treatment, non-compliance with schemes and recommendations, late seeking medical help can lead to the following complications in a nursing mother:

• Generalization of the infection. In women at this time, immunity is significantly reduced, regardless of whether there were complications in childbirth or not. Therefore, pneumonia occurs more often and progresses faster.
• Development of acute respiratory and heart failure, pulmonary edema. Delayed medical care can even lead to death in these situations.
• An abscess is a cavity filled with pus.
• The development of PE - pulmonary embolism - is a life-threatening condition.
• Pleurisy is an inflammation of the membrane that covers the chest and lungs.
• Exhaustion of the body can lead to a significant decrease in the production of breast milk.
• A sick mother is a source of pathogenic microbes for her baby and all family members.

Causes of pneumonia in a woman in labor

Pneumonia develops against the background of immunodeficiency states.

The postpartum period, especially if an operation or blood transfusion was performed, even with a woman's general well-being, is one of the most dangerous in terms of the risk of developing pneumonia.

The likelihood of pneumonia increases dramatically if a young mother has the following concomitant diseases:

• diabetes;
• HIV AIDS;
• drug, alcohol and nicotine addiction;
• chronic and lung;
• recent surgical interventions on the abdominal organs;
• with a forced long horizontal position (for example, with a divergence of the pubic joint, with fractures, etc.).

Pneumonia can be caused by various microorganisms, which determines the clinical picture and treatment tactics. The most common microbes that cause pneumonia are:

• pneumococci,
• staphylo- and streptococci,
• coli,
• mycoplasma and chlamydia,
• viruses (influenza, CMV and others),
• candida and others.

Microbes enter the lungs with inhaled air - the bronchogenic route. At the same time, they initially settle and begin to actively multiply even in the bronchi, causing all the signs of bronchitis. With good immunity and the absence of concomitant diseases, the disease ends at this stage. In the opposite case, inflammation affects the alveoli and other parts of the lungs, pneumonia occurs.

Much less often, pneumonia in a woman after childbirth can be caused by lymphogenous or hematogenous reflux of microbes. As a rule, this is observed in sepsis and other similar severe conditions.

Symptoms of pneumonia after childbirth by form

Symptoms of pneumonia after childbirth will depend on the form of pathology.

Typical

It is characterized by the following features:

• rise in body temperature to 38 - 40 degrees;
• at the same time there are pains behind the sternum, aggravated by breathing;
• cough with purulent sputum;
• when listening, wheezing is clearly defined and, without a doubt, pneumonia is confirmed during diagnostic procedures.

Atypical

It is characterized by the fact that all signs are blurred. In the first place are the symptoms of intoxication: weakness, lethargy, pain in muscles and joints, malaise. Therefore, this type of pneumonia is often mistaken for a common cold. The following is also typical:

• the temperature may have subfebrile values;
• cough dry or with scant amount of viscous white/clear sputum;
• in a diagnostic study, signs of inflammation are doubtful.

Croupous

It has the most vivid picture and unfavorable course. The following is typical:

• always acute onset, often after severe hypothermia;
• the high temperature rises sharply to 40 - 41 degrees;
• there is a cough with a thick, rusty-colored sputum;
• pain in the chest, as a large area of ​​\u200b\u200bthe lung or two at once is often captured;
• bright symptoms of the disease during the examination.

Secondary

It differs from all other species in that it occurs against the background of some kind of disease - HIV, heart failure, with prolonged forced horizontal position of the body, etc. The clinical picture is similar to typical pneumonia.

Watch a video about pneumonia:

Diagnosis of pneumonia after childbirth

Diagnosis of pneumonia is based on the woman's complaints, as well as the results of a visual examination and listening with a phonendoscope. To clarify the prevalence of the process and select the most optimal treatment regimens, the following additional examinations may be prescribed:

• X-ray of the chest organs.
• Sputum sampling and examination for various pathogens using the PCR method or seeding. Including this way, it is possible to determine the sensitivity of microbes to antibiotics, which will help in the future to prescribe the most rational treatment.
• CT, MRI, lung biopsy are performed in cases that are difficult to diagnose and for pneumonia that is not amenable to standard treatment.
• General clinical blood and urine tests, biochemistry, determination of specific antibodies.
• Paracentesis is a puncture of the pleural cavity, which is performed, for example, with the accumulation of inflammatory exudate in it.

In most cases, x-rays and sputum cultures are sufficient. This can be done on an outpatient basis - in the clinic.

Treatment of pneumonia after childbirth

Many lactating women after childbirth worry that they will have to stop breastfeeding during treatment. But today it is absolutely not necessary. The evidence for this is as follows:

• There are drugs that pass into breast milk in a minimal amount, so they can be taken by women during lactation without much concern.
• A sick mother is a source of infection for her baby. If she continues breastfeeding, ready-made antibodies will come to the baby. So he either does not get sick at all, or he will suffer a mild infection, like SARS or bronchitis.

For the treatment of pneumonia, the main thing is to choose the right drug to destroy the microbes that caused inflammation in the lungs. In 95% of cases, an antibacterial drug is needed. Ideally, if it is selected taking into account the sensitivity when sowing sputum or pleural fluid. More often than others, penicillins (Ampicillin, Amclavi and others), macrolides (Azithromycin, Clarithromycin, etc.), tetracyclines (Doxycycline and the like) are used.

To speed up recovery, antibiotics alone are not enough, a combination with other drugs is necessary. It is effective to use nebulizers for this - special devices for inhalation with drugs. O The main groups of funds are as follows:

• Antitussive and sputum thinning drugs. These are Bromhexine, ACC, Ambroxol, as well as medicinal plants - licorice root and others.
• Anti-inflammatory, which are especially needed when the temperature rises above 38 degrees. Usually this is an NSAID, for example, Ibuprofen can be used during lactation.
• Drugs that dilate the bronchi. They are necessary for spasmodic cough, as well as if a woman has bronchiectasis, bronchial asthma and other diseases. This group includes Berodual, Salbutamol and others.
• In some cases, immunostimulating agents, antiviral and some others are useful, based on the alleged causative agent of the disease.

The most effective treatment regimens can only be prescribed by a doctor. Self-medication in such situations can lead to the development of serious complications.

On average, recovery takes from a week to two. In some cases, pneumonia drags on for a month or more, as a rule, this happens in the presence of concomitant diseases, a severe immunodeficiency state (for example, HIV), and also with the development of complications.

Even if the disease can be cured in 7-10 days, asthenic syndrome can be observed for a long time - weakness, lethargy, apathy. At this time, it is useful to take various strengthening procedures.

It is effective to supplement the main treatment with physiotherapy - heating, magnetotherapy and other types.

Prevention of pneumonia in a woman in labor

Pneumonia is an infectious disease, so it can be prevented to some extent. Even during pregnancy, girls should pay attention to preventive measures, since with an increase in the period, the likelihood of getting sick is higher. The main recommendations are:

• It is necessary to avoid crowded places, small children, as it is most likely to catch pathogenic viruses or bacteria here. And if there are SARS patients in the family, it is better to avoid close contact with them.
• The rooms should be regularly ventilated and the air conditioners in the room should be properly maintained.
• It is important to maintain in a compensated state all chronic diseases.
• Bad habits should be abandoned.
• It is useful to enrich your diet with fresh fruits and vegetables.
• In some cases, it is necessary to carry out vaccination against both pneumococcus and viral diseases (influenza and others). This will drastically reduce the likelihood of an illness.

If pneumonia is transferred during pregnancy, how does childbirth go after

Pneumonia is also common during pregnancy. This is facilitated by a reduced level of immunity, as well as a reduced volume of the lungs, which are crushed by the growing uterus (after 30 weeks).

Pneumonia in early pregnancy can lead to disruption of the development of the embryo and even to complete fading.

Inflammation of the lungs at a later date can provoke the onset of labor, even much earlier than the due date.

It is optimal to carry out childbirth after the recovery of the woman. If this cannot be achieved, in the acute or subacute period of pneumonia, natural birth is preferable to caesarean section. In the latter case, there may be problems with both anesthesia and subsequent wound healing. When performing a caesarean section during pneumonia, spinal anesthesia is used more often than tracheal intubation.

Pregnancy and the postpartum period are accompanied, therefore, the likelihood of various infectious diseases, including pneumonia, increases. Treatment should be carried out by a doctor on an outpatient basis or in a hospital. Breastfeeding in most cases does not need to be stopped.